The present invention relates to a prescription medication dispensing apparatus for automatically effecting a physician prescribed medication program by selectively providing and withdrawing a prescribed dose of medication at desired times from a bulk medication loading format and also monitoring and communicating patient compliance with the medication program to a remote monitor or caregiver.
Doctors commonly prescribe a regimen of pills to be taken by ill persons, for example, a regimen such as xe2x80x9ctake two of the blue pills every six hours and one of the green pills every four hoursxe2x80x9d or the like is not uncommon. For some persons, such a specific regimen or course of medication may be easily followed. For other persons however, confusion can arise both concerning the schedule and concerning whether or not the medication has been taken. This problem occurs frequently where a large number of different medications are prescribed or with elderly persons who may have suffered some loss of mental faculties.
A variety of automated dispensers of pills which are purportedly aimed at some aspects of this dispensing problem are described in the related art. According to their respective descriptions these dispensers are intended to provide for dispensing of pills according to some specified regimen. In addition, in some cases, they have some described means to permit a determination of deviations from their programmed regimen. These dispensers, however have shortcomings in their complexity, cost, flexibility, ease of use and error resistance for use in many conventional medication dispensing needs.
Many dispensers which overcome the above noted drawbacks are highly dependent upon attention and diligence by caregivers. Some apparatus require the caregiver to properly fill the medication cups and stack them in the appropriate order in the device for subsequent dispensing. Other apparatus require the care giver to place medication into small containers within the dispenser. Thus, the use of such a device requires substantial amounts of handling and effort by a knowledgeable caregiver which is expensive and susceptible to error.
Wherefore, it is an object of the present invention to overcome the above mentioned shortcomings and drawbacks associated with the prior art.
It is an object of this invention to provide an on-site medication dispensing unit that is readily programmable for dispensing pills to a patient over an extended period of time and which monitors patient compliance with the programmed medication regime.
Another object of this invention is to prevent overdosing or multiple dosages in the unit""s output mechanism by having a visual and/or audible alerting feature which notifies the patient at a prescribed dosage time in accordance with the regimen that is programmed into the unit and then, and having a limited time window during which the patient must press a button or similar input device to activate the unit""s output mechanism to effect a physical dispensing of the dosage from the unit. The time window is reprogrammable. If the patient has not pressed the button or activated the input device when the time window ends, the dosage is inaccessible to the patient. This missed medication can be reissued to the patient the following delivery or day if appropriate or will be locked away until the caregiver intervenes. A further feature of the unit alerts the patient in steps of escalating intensity, either audibly and visually, or both, if the button or similar input device is not activated.
It is another object of this invention to provide a medication dispensing unit which is directly linked to a 24-hour monitoring facility or directly to a caregiver if an occurrence that is defined by the unit""s program to be an emergency situation arises. An example emergency situation is the patient""s failure to activate the dispensing button which, as described above, causes the dosage to be inaccessible to the patient. If this occurs more than a predetermined number of times over a predetermined time duration, it would cause an alert to be sent directly to a caregiver and/or an alert to a monitoring facility.
Another object of the present invention is to provide a medication dispensing device which permits bulk loading of the device for at least a 30-day supply of medication.
A further object of the present invention is to provide a device which is capable of being resupplied from a chain pharmacy""s managed care pharmacy division in a bulk loading format.
Yet another object of the present invention is to provide a bulk loading format where once the bulk medication is loaded in the device, no further human interaction with the medications is necessary to dispense the appropriate dosages of medications.
A still further object of the present invention is to select a desired prescribed medication dosage from the bulk loading format and deliver the dosage to the patient for only a prescribed period of time.
One embodiment of the on-site medication dispenser unit includes a rotating carousel wherein the canisters carried by the carousel may be loaded with at least a week""s worth of a particular type of medication or types of medication. Anticipating when a medication dosage, or series of dosages is to be dispensed, the carousel is rotated so that the canister containing the appropriate pill is positioned at a selecting mechanism. The selecting mechanism selects a pill from the canister and drops it into a waiting receptacle, the selecting mechanism continues to select pills from individual canisters on the rotating carousel until a required dosage has been dropped into the receptacle.
At the prescribed dosage time the dispenser""s program initiates an alert to the patient. As described above, when the patient is alerted, he/she is required to push a dispensing button within a programmable time window. If the button is pushed, the aligned receptacle releases its contents into a chute accessible to the patient. If the patient does not dispense the medication when alerted to do so, the dispenser first, for certain embodiments, steps through a progressive alerting of audio (tones and prerecorded voice messages) and visual alerts with increasing intensity, and if the medicine is not dispensed, the medication remains in the collection receptacle where it is inaccessible to the patient and the unit attempts to contact, in order, a preprogrammed list of caregivers and then if not successful, notifies the 24-hour central monitoring facility.
A still further embodiment of the invention provides a dispensing unit programmable to notify a patient to take a medication which is not dispensed by the unit. One example is the dispenser prompting the patient to take insulin using the above-identified visual display audible alarm and/or an audio message such as a prerecorded voice.
According to one example embodiment, the on-site dispensing unit is loaded by first filling the appropriate plurality of canisters, with the individual medication prescriptions, then transporting the filled canisters to the on-site unit, and loading them into the dispensing mechanism""s canister carousel. The medication prescription canisters may be filled at the location of the on-site unit, or prefilled at a central distribution facility, or at a local station, such a place within a nursing home.
After loading the bulk medications into the canisters, the unit is programmed using one of the following three methods; call the central monitoring facility and have the unit programmed remotely, use a setup panel to select a preprogrammed standard, use a setup control panel to enter in a customized schedule.
A control panel for programming the dispensing unit is preferably located under a cover of the dispensing unit thereby, preventing accidental or other altering of the stored medication dosage schedule.
In addition to the medication dispensing and monitoring functions of the dispensing unit, a further embodiment includes a wireless communicating device worn by the patient which is communicatively linked with the dispenser to provide additional emergency protection to some patients. In an emergency, the patient can activate the wireless communication device which would communicate with the dispensing unit. The dispensing unit would, in turn, send an emergency message to the central monitoring station. The personal communication device may be.a pendant worn around the neck or any other suitable device that can be worn on the patients body. The medication dispensing unit may optionally incorporate an emergency button that serves the same function as the personal communication device. Other embodiments of the wireless emergency communications device are a wall mounted wireless emergency button and a table top wireless emergency button.
The present invention also relates to a medication preparation and dispensing apparatus for selecting and delivering at least one prescribed medication from a plurality of bulk medication amounts to a patient, the preparation and dispensing apparatus comprising a housing accommodating a plurality of receptacles containing the bulk medication amounts and a selection mechanism for obtaining the at least one prescribed medication from at least one of the plurality of receptacles, a medication dosage holder for collecting the at least one prescribed medication from the selection mechanism, a dispenser for dispensing the at least one medication collected by the medication dosage holder to the patient within a desired time period, and wherein a programmable computer instructs the selection mechanism to obtain the at least one medication from the bulk medication amounts and deliver the at least one medication to the dosage holder, the computer also communicating with the dispenser to issue the at least one medication to the patient within the desired time period.